Psychological Disorders

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Psychological Disorders
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• People are fascinated by the abnormal, the
  unusual, and the exceptional. Why?
• To study the abnormal is the best way of
  understanding the normal William James
• One reason may be that we/family/friends have
  felt the pain of a psychological disorder.

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Where Do We Draw The Line Between Normality and
Disorder?

• How do we define psychological disorders?
• How should we understand pds.
• How might we classify pds.

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• Please write down three criteria you believe
  could be used to define abnormal behavior.
• You will be using this criteria to determine the
  relative mental health of a case study you will
  be given.
• You might begin by using the prompt "Behavior
  might be considered psychologically disordered if
  it is .

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Defining Psychological Disorders

• Psychological Disorder- UMAD
• a harmful dysfunction in which behavior is
  judged to be
• atypical- not enough in itself
• disturbing- varies with time culture

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• maladaptive- harmful. The key element in
  defining a disorder. The behaviors must be
  distressing or disabling or put one at greatly
  increased risk of suffering or death.
• Examples Emotional withdrawal
• Eating disturbance
• Sleep disturbance
• Impulsivity

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• unjustifiable-abnormal behavior is most likely to
  be considered disordered when others find it
  rationally unjustifiable.
• One person says they hear voices. A celebrity
  could say the same thing and not be thought of as
  irrational.

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• UMAD

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• Understanding Psychological Disorders

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Historical Perspective

• Perceived Causes
• movements of sun or moon
• lunacy- full moon
• evil spirits
• Ancient Treatments
• exorcism, caged like animals, beaten, burned,
  castrated, mutilated, blood replaced with
  animals blood.

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Trephining

• A chipping of holes in the skull to let out evil
  spirits.

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Psychological DisordersPerspectives

• Medical Model
• Most reliable
• concept that diseases have physical causes
• can be diagnosed, treated, and in most cases,
  cured

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Nature and Nurture

• Bio-psycho-social Perspective
• assumes that biological, sociocultural, and
  psychological factors combine and interact to
  produce psychological disorders

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• Quiz Reminder
• 11.19.10
• Covers Motivation and Emotion
• All multiple choice

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• Classifying Psychological Disorders

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• In biology and the other sciences, classification
  creates order.
• In order to study a disorder we must first name
  and describe it.

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Psychological Disorders

• DSM-IV
• American Psychiatric Associations Diagnostic and
  Statistical Manual of Mental Disorders (Fourth
  Edition)
• a widely used system for classifying
  psychological disorders
• The DSM-IV defines 17 major categories of mental
  disorders.

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• Labeling Psychological Disorders

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Multiaxial Classification
Is a Clinical Syndrome (cognitive, anxiety, mood
disorders 16 syndromes) present?
Axis I
Is a Personality Disorder or Mental Retardation
present?
Axis II
Is a General Medical Condition (diabetes,
hypertension or arthritis etc) also present?
Axis III
Are Psychosocial or Environmental Problems
(school or housing issues) also present?
Axis IV
What is the Global Assessment of the persons
functioning?
Axis V
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Sample Classification

• Example Diagnosis
• Axis I 296.84 Bipolar II Disorder, Early Onset.
• Axis I 307.51 Bulimia Nervosa, Nonpurging Type.
• Axis II 301.6 Dependent Personality Disorder
• Axis III 426.00 Complete Atrioventricular Block
• Axis IV Child abuse victim, unemployment

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DSM, cont.

• Axis V 28
• Based on a 100 point scale
• 21-30Behavior is considerably influenced by
  delusions or hallucinations OR serious impairment
  in communication or judgment (e.g., sometimes
  incoherent, acts grossly inappropriately,
  suicidal preoccupation ) OR inability to function
  in almost all areas ( e.g., stays in bed all day,
  no job, home, or friends ).

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• Why do we label disorders?
• What might be the disadvantages of labeling?

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• Anxiety Disorders

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• In your spiral, please make a list of your top 5
  fears.
• Penn State Worry Questionnaire

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• Reverse the responses to items 1,3,8,10, and 11

Scores can range from 16 to 80 -Higher scores
reflect a greater tendency to worry -Average
scores for 405 intro psych students was
48.8 -Females 51.2 -Males46.1
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Anxiety Disorders

• Anxiety Disorders
• distressing, persistent anxiety or maladaptive
  behaviors that reduce anxiety
• Generalized Anxiety Disorder
• person is tense, apprehensive, and in a state of
  autonomic nervous system arousal
• Person cannot articulate reason for anxiety.
• Heart pounding, cold sweat.

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• Phobia
• Phobias focus anxiety on a specific object,
  activity, or situation.
• Phobias are irrational fears that disrupt
  behavior.

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• 530 and counting

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• Agoraphobia is literally translated as "fear of
  the market place." Modern medicine has pinned it
  down to a fear of having a panic attack and often
  the fear of having others notice it.
• Avoiding potentially anxiety producing situations
  from which escape my be difficult.

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Anxiety Disorders

• Common and uncommon fears

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Discovery Health ChannelPhobia Study

• Top Ten Fears of Men and Women Combined
• Snakes
• Being burned alive
• Heights
• Being bound or tied up
• Drowning
• Public speaking
• Hell
• Cancer
• Tornadoes and hurricanes
• fire

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• Top 5 fears of Men
• Being buried alive
• Heights
• Snakes
• Drowning
• Public speaking

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• Top 5 Fears of Women
• Snakes
• Being bound or tied up
• Being buried alive
• Heights
• Public speaking

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Anxiety Disorders

• Obsessive-Compulsive Disorder
• characterized by unwanted repetitive thoughts
  (obsessions) and/or actions (compulsions)
• OCD thoughts and behavior cross the line between
  normality and disorder when they become so
  persistent that they interfere with the way we
  live or cause distress.

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OCD-6 Components that produce common symptoms.

• Washing- 5, 11, 17
• Obsessing- 6,12, 18
• Hoarding-1, 7, 13
• Ordering-3, 9, 15
• Checking-2,8, 14
• Mental Neutralizing- 4, 10, 16

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Anxiety Disorders
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• Panic Disorder
• marked by a minutes-long episode of intense dread
  in which a person experiences terror and
  accompanying chest pain, choking, or other
  frightening sensation

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Explaining Anxiety Disorders

• Anxiety is both a feeling and a cognition-a doubt
  laden appraisal of ones safety or social skill.
• Freud felt that beginning in childhood, people
  repress intolerable feelings, impulses, and
  ideas. This submerged mental energy sometimes
  produced symptoms such as anxiety.

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Learning Perspective

• Fear Conditioning. When bad events happen
  unpredictably and uncontrollably, anxiety often
  develops.
• Researchers have linked general anxiety with
  classical conditioning of fear.

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• In the lab, they have created chronically
  anxious, ulcer prone rats by giving them
  unpredictable electric shocks.

Please help us
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• Stimulus Generalization
• Conditioned fears may remain long after we have
  forgotten the experiences that produced them.
• A person who fears heights after a fall may be
  afraid of flying without ever have flown.

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• Reinforcement
• Once phobias and compulsions arise, reinforcement
  helps maintain them.
• Avoiding or escaping the feared situation reduces
  anxiety.
• Compulsive behavior also reduces anxiety.

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• Observational Learning
• We might also learn fear from observing others
  fears.
• Monkeys and humans can transmit their fears to
  their offspring/children.

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Biological Perspective

• Evolution.
• Humans appear to be biologically prepared to fear
  dangers faced by our ancestors.
• Most our phobias focus on objects like-spiders,
  snakes, etc.
• Fear can be a healthy thing.

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• Many of modern day fears have evolutionary
  explanations.
• Fear of flying may also come from our biological
  past, which predisposes us to fear confinement
  and heights.

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• Genes.
• Some people seem genetically predisposed to
  particular fears and anxiety.
• Identical twins often develop similar phobias.

Please go back to the list of 5 fears that you
were asked to generate.
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• Physiology
• GAD, panic attacks, and even OCD are biologically
  measurable as an over arousal of brain areas
  involved in impulse control.
• PET scans of persons with OCD show an unusually
  high activity in the frontal lobe just above the
  eyes.

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Anxiety Disorders

• PET Scan of brain of person with Obsessive/
  Compulsive disorder
• High metabolic activity (red) in frontal lobe
  areas involved with directing attention

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• Mood Disorders

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• In the Western world, more and more youth and
  younger adults have suffering depression.

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Mood Disorders

• Mood Disorders
• Characterized by emotional extremes
• Two principal forms

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Depression

• Depression is the common cold of psychological
  disorders.
• Although phobias are more common, depression is
  the 1 reason that people seek mental health
  services.

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Anxiety v. Depression

• Depression is a signal for us to stop and reflect
  on why we are feeling threatened.
• In a way the suffering makes sense.
• Automatic Thoughts Survey

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• Survey highlights most important symptoms
• Desire for change-14 and 20
• Negative expectations-3 and 24
• Low self-esteem-17 and 18
• Helplessness-29 and 30

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Scores

• Range from
• 30-little to no depression
• 150-maximum depression

The mean score for the sample with depression was
79.6. The mean score for non-depressed samples
was 48.6.
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Depression can affect memory

• When we are in a bad or sad mood, we are more
  likely to remember unpleasant events.
• I am going to read you a series of individual
  words.
• After each word I am going to pause so that you
  can think of a past experience you associate with
  that word.
• Please write down that experience in a sentence
  or two if you have the time.

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Two Principal Forms of Mood Disorders

• 1st Form- Major Depressive Disorder
• a mood disorder in which a person, for no
  apparent reason, experiences two or more weeks of
  depressed moods, feelings of worthlessness, and
  diminished interest or pleasure in most
  activities
• Combine the anguish of grief with jet lag.
• More women suffer from major depression than men.

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• "Good morning, Eeyore," said Pooh."Good morning,
  Pooh Bear," said Eeyore gloomily."If it is a
  good morning," he said, "Which I doubt," said
  he.A.A. Milne, The House at Pooh Corner

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• 2nd Form Bipolar Disorder
• a mood disorder in which the person alternates
  between the hopelessness and lethargy of
  depression and the overexcited state of mania.
• Sometimes people rebound to the opposite end of
  the spectrum.
• formerly called manic-depressive disorder

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• One of manias maladaptive symptoms is grandiose
  optimism and self-esteem.
• During a manic episode, a person might
  impulsively quit a job, charge up huge amounts on
  credit cards, or feel rested after sleeping two
  hours.

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• During a depressive episode, the same person
  might be too tired to get out of bed and full of
  self-loathing and hopelessness over being
  unemployed and in debt.

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• Bipolar disorder is especially common in creative
  artists.
• Examples Ernest Hemingway, George Frederic
  Handel, Walt Whitman, Edgar Allan Poe, Virginia
  Woolf, and Mark Twain

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Causes of Bipolar Disorder

• The causes of bipolar disorder arent completely
  understood, but it often runs in families. The
  first manic or depressive episode of bipolar
  disorder usually occurs in the teenage years or
  early adulthood.

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Explaining Mood Disorders

• Depression and its causes has the subject of
  thousands of studies.
• Psychologists are working to develop theories for
  the causes of depression.

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The Biological Perspective

• Researchers believe that depression is a
  whole-body disorder
• It involves genetic predispositions, biochemical
  imbalances, melancholy moods, and negative
  thoughts.

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• Drugs that alleviate mania reduce norepinephrine.
• Drugs that relieve depression tend to increase
  norepinephrine or serotonin by blocking their
  reuptake. Prozac, Zoloft.
• Physical exercise also increases serotonin.

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• Modern scanning procedures can spot neurological
  signs of depression.
• Recent studies show that the brains of depressed
  people are less active in a depressed state.

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Mood Disorders-Bipolar

• PET scans show that brain energy consumption
  rises and falls with emotional swings

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The Social-Cognitive Perspective

• Some people slide into depression even when
  things are going well.
• Biological factors accompany psychological
  reactions to experience.
• The minds negative thoughts somehow influence
  biochemical events that amplify depressing
  thoughts.

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Mood Disorders-Depression

• Altering any one component of the
  chemistry-cognition-mood circuit can alter the
  others

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• This self-defeating attitude may come from
  learned helplessness.
• Animals and humans act depressed, passive, and
  withdrawn after experiencing uncontrollable
  painful events.
• Women more often than men have been abused or
  made to feel helpless.

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• Negative Moods Feed Negative Thoughts
• Self-defeating thoughts, self-blame, and
  attribution support depression.
• But do they cause depression?

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Suicide

• Each year ¾ of million people choose suicide as a
  permanent solution to what may be a temporary
  problem.
• To find out who commits suicide, researchers have
  compared the suicide rates of different groups.

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• Racial Differences. White Americans are nearly
  twice as likely as black Americans to kill
  themselves.

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• Gender Differences. Women are more likely than
  men to commit suicide.

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• Age Differences. Due partly to better reporting,
  the known suicide rate among 15-19 year olds has
  more than doubled in the US since 1950. It now
  nearly equals the traditional suicide rate among
  adults.

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• Other Group Differences. Suicide rates are higher
  among
• The rich
• The nonreligious
• Those who are single, widowed, or divorced.

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• In most Native American communities, youth
  suicide rates are three times higher than the
  U.S. national average. Randy Grinnell, the Indian
  Heath Service Deputy Director, said its
  essential to detect early warning signs and treat
  mental illness to prevent suicides.

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• On Monday, February 12 2007, the U.S. Center for
  Disease Control and Prevention released its
  Annual Summary of Vital Statistics. Inside the
  report, suicide rates for children and
  especially teens appeared to have rose
  dramatically over a one-year time period, 2003 to
  2004.

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Mood Disorders- Suicide
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• What Cause Suicide?
• Risk factors for suicide include mental disorder
  (such as depression, personality disorder,
  alcohol dependence, or schizophrenia), and some
  physical illnesses.

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• Neurological disorders, cancer, and HIV infection
  are a major risk factor for suicide in Europe and
  North America

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• In Asian countries impulsiveness plays an
  important role. Suicide is complex with
  psychological, social, biological, cultural and
  environmental factors involved.

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Somatoform Disorders

• These disorders occur when a person manifests a
  psychological problem through a physiological
  symptom.
• A person experiences a physical problem in the
  absence of a physical cause.

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• Hypochondriasis Physical complaints for which
  medical doctors are unable to locate the cause.
• Patient may believe that a minor problem, like a
  headache, are indicative of a severe illness even
  when no evidence of an illness exists.

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• Conversion-Patient reports the existence of a
  severe medical problem such are paralysis or
  blindness.
• No biological reason for this problem can be
  located.

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• Causes of Somatoform Disorders
• -Psychodynamic
• -Behaviorists

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Dissociative Disorders

• Dissociative Disorders
• conscious awareness becomes separated
  (dissociated) from previous memories, thoughts,
  and feelings

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• Psychogenic Fugue
• Now called Dissociative fugue traveling fugue
• It involves one or more episodes of sudden,
  unexpected, but purposeful travel from home
  during which people cannot remember some or all
  of their past life, including who they are (their
  identity). These episodes are called fugues.

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A man who walked into a police station five years
after he was presumed dead in a canoeing accident
has told officers he has no memory of what
happened to him
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• Dissociative Identity Disorder
• rare dissociative disorder in which a person
  exhibits two or more distinct and alternating
  personalities
• formerly called multiple personality disorder
• People with DID commonly have a history of sexual
  abuse or some other terrible childhood trauma.

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Causes of Dissociative Disorders

• Freud
• Behaviorists
• Cases of DIDs are rare outside the US.

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Revisit

• What are the mood disorders?
• What are the somatoform disorders?
• What the dissociative disorders?

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PTSD

• Posttraumatic stress disorder (PTSD) is an
  anxiety disorder that can occur after you have
  been through a traumatic event.

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• Anyone who has gone through a life-threatening
  event can develop PTSD. These events can include
  
• Combat or military exposure
• Child sexual or physical abuse
• Terrorist attacks
• Sexual or physical assault
• Serious accidents, such as a car wreck.
• Natural disasters, such as a fire, tornado,
  hurricane, flood, or earthquake.
• After the event, you may feel scared, confused,
  or angry. If these feelings don't go away or they
  get worse, you may have PTSD. These symptoms may
  disrupt your life, making it hard to continue
  with your daily activities.

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Symptoms of PTSD

• Reliving the event (also called re-experiencing
  symptoms)
• Avoiding situations that remind you of the event
• Feeling numb
• Feeling keyed up (also called hyperarousal)
• Youtube

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Psychotic Disorders

• Schizophrenia
• Mapping Brain Tissue Loss in Adolescents with
  Schizophrenia. This map reveals the 3-dimensional
  profile of gray matter loss in the brains of
  teenagers with early-onset schizophrenia, with a
  region of greatest loss in the temporal and
  frontal brain regions that control memory,
  hearing, motor functions, and attention

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• T 18. F
• T 19. T
• T 20. T
• T 21. T
• 22. F
• F 23. F
• T 24. T
• T 25. T
• T 26. T
• T 27. T
• F 28. T
• F 29. T
• T 30. T
• T

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Schizophrenia

• What forms does schizophrenia take?
• And what are its possible causes.

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Schizophrenia

• Schizophrenia
• literal translation split mind
• a group of severe disorders characterized by
• disorganized and delusional thinking
• disturbed perceptions
• inappropriate emotions and actions

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Schizophrenia

• Delusions
• false beliefs, often of persecution or grandeur,
  that may accompany psychotic disorders
• Hallucinations-Disturbed Perceptions
• false sensory experiences, perceiving things that
  are not there.
• Usually auditory
• Hearing voices.

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• Inappropriate Emotions
• Laughing when recalling a death in the family

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Types of Schizophrenia

• Schizophrenia is not a single disorder.
• It is a cluster of disorders.
• The subtypes share common features but also have
  distinguishing features.

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Schizophrenia
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Symptoms

• Positive symptoms (Presence) Patients may
  experience hallucinations, are often
  disorganized, and deluded in their talk.
• Negative symptoms (Absence) Patients may have
  toneless voices, expressionless faces, rigid
  bodies.

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Understanding Schizophrenia

• If depression is the common cold of psychological
  disorders, schizophrenia is the cancer.
• Most recent studies link it with brain
  abnormalities and genetic predispositions.

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Possible Causes of Schizophrenia

• Brain Abnormalities-Dopamine Overactivity,
  Problems with brain structures.
• Viral connection
• Genetic connection
• Psychological triggers
• Birth Complications

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Schizophrenia
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• Personality Disorders

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• Some maladaptive behavior patterns impair
  peoples social functioning without anxiety,
  depression, or delusion.
• For society the most troubling of these is the
  antisocial personality disorder.

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Personality Disorders

• Personality Disorders
• disorders characterized by inflexible and
  enduring behavior patterns that impair social
  functioning

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• Borderline Personality Disorder
• persons with this disorder present instability in
  their perceptions of themselves, and have
  difficulty maintaining stable relationships.
• Persons with borderline personality disorder
  often feel as though they lacked a certain level
  of nurturing while growing up and, as a result,
  incessantly seek a higher level of caretaking
  from others as adults.

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Personality Disorders

• Antisocial Personality Disorder
• The most troubling impulsive disorder.
• Formerly called a sociopath or psychopath

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• Disorder in which the person (usually man)
  exhibits a lack of conscience for wrongdoing,
  even toward friends and family members
• May be aggressive and ruthless or a clever con
  artist

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• Dennis Lynn Rader (born March 9, 1945) murdered
  ten people in an around Wichita, between 1974 and
  1991.
• He was known as the BTK killer (or the BTK
  strangler), which stands for "bind, torture and
  kill. He sent letters describing the details of
  the killings to police and to local news outlets
  during the period of time in which the murders
  took place.
• After a long hiatus in the 1990s, Rader resumed
  sending letters in 2004, leading to his 2005
  arrest and subsequent conviction.

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• In comparing the brains of murderers with people
  of similar age and sex, research has shown
  reduced activity in the frontal lobes of the
  murderers.

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Personality Disorders

• PET scans illustrate reduced activation in a
  murderers frontal cortex

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Rates of Psychological Disorders

• How prevalent are the different psychological
  disorders?
• Does the risk of having a specific disorder vary
  with ones ethnicity or gender?

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Findings

• Incidence of psychological disorders is doubly
  high among those below the poverty line.
• Those who experience a psychological disorder
  usually do so by early adulthood.

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Personality Disorders
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Rates of Psychological Disorders